Hi Katherine and others,

I taught birth classes in a large hospital system (3 different sites, 11
classes per week) and insted of a separate birth class, wove breastfeeding
into each session, a sentence here, a paragraph there.  I taught latch &
positioning immediately following "surprise, out-of-hospital birth." The
couples were usually spellbound when I discussed the two major risks: baby
not breathing, and mom bleeding too heavily. After learning how to call for
emergency help, they practiced "rescue breathing" on their forearms to deal
with the baby. For the bleeding, the message was "baby should go to breast
and here's how."  Invariably someone would ask, "if it's so important to BF
immediately if we don't make it to the hospital, isn't it important even if
we do?"  A - HAH! GOTCHA!  Open door, in goes explanation.  Worked every
time. Talk about a teachable moment!

The trick is to treat BF as the expected sequelae. Stage 1 labor; stage 2
birth; stage 3 baby is at breast and placenta delivers; stage 4 recovery for
mother-baby dyad. Together, of course.  I think many (most?) first-time
parents are so terrified of dying of pain during the birth (or something
else) that they just can't focus on the baby till it's out.  It's too great a
leap of faith to think about "day after" issues, including feeding.

While I'm on my soapbox - the 3 survival skills to teach everyone are, in
order: (1) how to make milk, (2) how to hold the baby so BF is comfortable,
and (3) where to get help if BF hurts or you think the baby isn't eating
well.  That's the core stuff that you can't do without. Other information is
nice but isn't important at 2 a.m. when faced with a hungry baby.  Save the
"why" information till after - get them started with the how-to FIRST.

Linda Smith, BSE, FACCE, IBCLC (yes, 11 classes per week is nuts!)
Dayton OH